Tim GilmerAs I write this, I’m waiting … waiting for an insurance pre-authorization for an MRI. During a cystoscopy a few days ago, my urologist discovered a mass in my urethra that is potentially malignant. On the other hand, it might be a benign, chronic abscess. Whatever it is, I want it out of me, but the insurance company is taking its sweet time to consider whether an MRI, followed by surgery, is “cost-effective.”

The insurance company doesn’t actually do the considering. They contract with another company, American Imaging Management, which will tell them if they should approve the MRI or not. This is the American way of doing what is referred to as “health care,“ a system where doctors must be subservient to the almighty dollar. Cost is primary; care secondary. As I wait to hear if I have cancer or not, the management model, which takes much longer to run its twisted course than a doctor’s order, makes me very anxious.

I think back to my lifelong friend, Loon, who got trapped in the management model when he was told he had metastatic mel¬anoma, a deadly cancer. He died in 2010 after a year-l